Funding is requested to revise for publication the grant applicant's Ph.D. dissertation entitled "A Necessary Revolution: The Origins of the Kaiser Permanente Medical Care Program". The dissertation traces the first two decades of Kaiser Permanente development from its inception as an industrial health plan for Henry J. Kaiser's workforce at Grand Coulee Dam in the late 1930s, and at the Kaiser shipyards and steel plant on the West Coast during World War II. The Kaiser Health Plan and comprehensive medical care program was opened for public membership in July 1945, after it dwindled at the end of the war to only a few thousand subscribers. Within a decade it grew to over 500,000 members; today it has expanded nationwide and has a membership of over five million. It is recognized as the most successful private sector comprehensive health maintenance organization (HMO) in the nation, and is a prototype for the hundreds of HMOs established since passage of the 1973 National Health Maintenance Organization Act. Publication by an academic press of the Kaiser Permanente study will be an important contribution to knowledge as a model for evaluation of HMOs established in the 1970s and 1980s. The factors for success as dominant themes in the study are: exceptional entrepreneurial and professional leadership; the ideological commitment and practical dedication of key Permanente physicians and lay managers to serve the public interest; the resolution of corporate- professional tensions within the organization, and between Permanente executives and the American Medical Association; the financial resources and political influence of Henry J. Kaiser and Kaiser Industries as a corporate entity; and the support of organized labor and working class consumers. With additional research and revision the applicant proposes to further test these factors using models of professionalization, interest group alignment, social benefit, and economic efficiency. Editorial revision will aim at condensation of the manuscript to a length appropriate for publication.